The enzyme targeted by a new class of experimental antimalarial drugs has been identified, raising hope of a treatment that can cure, prevent and block transmission of the disease.
The enzyme is vital for the growth and development of multiple species of the Plasmodium parasites that cause malaria and is required at all stages in the parasite life cycle. It is the first pre-clinically validated drug target that is active at all stages in the parasite life cycle, laying the foundations for the development of next-generation antimalarial drugs.
To eliminate malaria, medicines need to be effective against the dormant liver-stage infection that can cause relapses, as well as the symptomatic blood stage, and should also block transmission of the parasite to mosquitoes that spread the disease.
The imidazopyrazines are a new class of experimental antimalarial drugs that are being developed by scientists at Novartis with support from the Wellcome Trust and the Medicines for Malaria Venture. They have potent preventive, therapeutic and transmission-blocking activity in animal models of malaria and are also effective against two species of malaria parasite taken from patient samples. However, until now, the target of this class of experimental drugs was not known.
To investigate this, the international team created parasite strains in the laboratory that are resistant to treatment with the imidazopyrazines and then used genetic sequencing to identify the genes that are mutated to confer resistance. In all cases, the mutation occurred in the gene for PI4K, an enzyme involved in fatty acid metabolism that is active across all stages in the parasite life cycle.
Thierry Diagana, Head of the Novartis Institute for Tropical Diseases, said: "This new target for malaria provides an avenue to develop the next-generation antimalarial drugs that are capable of preventing, treating and blocking the spread of malaria."
Dr Richard Seabrook, Head of Business Development at the Wellcome Trust, said: "With growing resistance to existing therapies, we urgently need new malaria medicines to combat the spread of this deadly disease. This discovery is particularly exciting as it identifies a druggable target that is effective in multiple species of the malaria parasite and at all stages of the parasite life cycle, features that are considered vital for a treatment capable of eliminating malaria."
The imidazopyrazine compounds used in this study may serve primarily as tools for understanding more about the biology of the malaria life cycle; however, the authors suggest that further optimisation could lead to clinical candidates with desirable drug-like characteristics.
The paper, Targeting Plasmodium PI(4)K to eliminate malaria, is published in Nature.
